The diagnostic value of MRI diffusion kurtosis imaging and diffusion tensor imaging in early Wallerian degeneration of corticospinal tract in cerebral small-vessel disease

doi:10.3877/cma.j.issn.2095-655X.2020.04.012

Abstract

Abstract:

Objective

By analyzing MRI diffusional kurtosis imaging (DKI) and diffusion tensor imaging (DTI) of corticospinal tract (CST) in cerebral small-vessel disease (CSVD), the study compared their diagnostic value to detect the microstructures of early Wallerian degeneration(WD).

Methods

From September 2016 to April 2018, 56 patients diagnosed as CSVD in the Department of Neurology in the Second Affiliated Hospital of Shantou University Medical College, and indicated as lacunar infarction on MRI were selected as CSVD group, and 24 patients without positive findings on MRI were selected as the control group, all of them underwent DKI scan. According to the different lesion sites in MRI T₂-Flair, CSVD group was divided into 4 groups, including pons group (A1 group), forepart of posterior limb of internal capsule group (A2 group), corona radiata group (A3 group) and subcortex group (A4 group). The mean kurtosis (MK), mean diffusion(MD) and fractional anisotropic of tensor (FA) were measured on the seemingly normal white matter areas on both sides of the descending fiber bundle in pons, forepart of posterior limb of internal capsule, corona radiata and subcortical area.

Results

MK values of pons in the A1, A2, A3 and A4 group (1.19±0.11, 1.18±0.11, 1.20±0.10 and 1.20±0.09, respectively) were higher than those in the control group (1.05±0.12), which showed significant differences (t=-3.47, -4.10, -5.29, -5.40, all P<0.01). MK values of subcortex in the A1, A3 and A4 group (1.00±0.08, 1.00±0.13 and 0.99±0.13, respectively) were higher than those in the control group (0.92±0.12), which showed significant differences (t=-2.12, -2.22, -2.11, all P<0.05). In four subgroups, the number of brain regions with statistical significance (P<0.05) in MK, MD and FA, they were 7, 1 and 2, respectively.

Conclusion

DKI is more sensitive than DTI in detecting the microstructure of early WD when there is no positive result in conventional MRI.

Key words: Cerebral small-vessel disease, Corticospinal tract, Wallerian degeneration, Diffusional kurtosis imaging, Diffusion tensor imaging

Silan Chen, Yuelin Guo, Lingmei Kong, Haibing Rao, Wei Chen, Wenbin Zheng, Renhua Wu. The diagnostic value of MRI diffusion kurtosis imaging and diffusion tensor imaging in early Wallerian degeneration of corticospinal tract in cerebral small-vessel disease[J]. Chinese Journal of Diagnostics(Electronic Edition), 2020, 08(04): 275-280.

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References 16

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部位		变化幅度	统计量	P值
脑桥[M(P₂₅，P₇₅)]		?	H＝45.89	<0.01
?	MK	0.14(0.09，0.21)	?	?
?	MD	0.04(0.03，0.07)	?	?
?	FA	0.13(0.05，0.23)	?	?
内囊后肢前部(±s)		?	F＝4.21	<0.05
?	MK	0.08±0.05	?	?
?	MD	0.05±0.04	?	?
?	FA	0.07±0.05	?	?
放射冠[M(P₂₅，P₇₅)]		?	H＝53.72	<0.01
?	MK	0.06(0.03，0.09)	?	?
?	MD	0.04(0.02，0.08)	?	?
?	FA	0.20(0.10，0.28)	?	?
皮层下[M(P₂₅，P₇₅)]		?	H＝59.63	<0.01
?	MK	0.10(0.05，0.18)	?	?
?	MD	0.05(0.03，0.07)	?	?
?	FA	0.22(0.10，0.36)	?	?

部位		变化幅度	统计量	P值
脑桥[M(P₂₅，P₇₅)]		?	H＝45.89	<0.01
?	MK	0.14(0.09，0.21)	?	?
?	MD	0.04(0.03，0.07)	?	?
?	FA	0.13(0.05，0.23)	?	?
内囊后肢前部(±s)		?	F＝4.21	<0.05
?	MK	0.08±0.05	?	?
?	MD	0.05±0.04	?	?
?	FA	0.07±0.05	?	?
放射冠[M(P₂₅，P₇₅)]		?	H＝53.72	<0.01
?	MK	0.06(0.03，0.09)	?	?
?	MD	0.04(0.02，0.08)	?	?
?	FA	0.20(0.10，0.28)	?	?
皮层下[M(P₂₅，P₇₅)]		?	H＝59.63	<0.01
?	MK	0.10(0.05，0.18)	?	?
?	MD	0.05(0.03，0.07)	?	?
?	FA	0.22(0.10，0.36)	?	?

组别	脑桥			内囊后肢前部
组别	MK(±s)	MD[mm²/s，M(P₂₅，P₇₅)]	FA(mm²/s，±s)	MK	MD(mm²/s)	FA(mm²/s)
A1组	1.19±0.11	0.63(0.61，0.65)	0.48±0.11	1.13±0.11	0.68±0.04	0.63±0.05
A2组	1.18±0.11	0.62(0.60，0.64)	0.48±0.11	1.14(1.07，1.26)^a	0.67(0.64，0.70)^a	0.65(0.60，0.69)^a
A3组	1.20±0.10	0.62(0.60，0.65)	0.49±0.10	1.20(1.09，1.28)^a	0.67(0.63，0.70)^a	0.66(0.61，0.70)^a
A4组	1.20±0.09	0.62(0.60，0.65)	0.48±0.10	1.17±0.13	0.67(0.63，0.70)	0.65±0.06
对照组	1.05±0.12	0.64(0.61，0.66)	0.47±0.08	1.18±0.14	0.67±0.05	0.67±0.06
组别	放射冠			皮层下
组别	MK	MD[mm²/s，M(P₂₅，P₇₅)]	FA(mm²/s，±s)	MK(±s)	MD(mm²/s，±s)	FA(mm²/s，±s)
A1组	1.14(1.05，1.18)^a	0.64(0.61，0.66)	0.39±0.10	1.00±0.08	0.68±0.04	0.44±0.11
A2组	1.13±0.08	0.63(0.61，0.66)	0.36±0.10	0.96±0.13	0.68±0.05	0.43±0.10
A3组	1.15±0.10	0.63(0.60，0.66)	0.37±0.10	1.00±0.13	0.68±0.04	0.47±0.11
A4组	1.14±0.10	0.63(0.60，0.66)	0.36±0.10	0.99±0.13	0.68±0.04	0.46±0.11
对照组	1.10±0.13	0.63(0.60，0.66)	0.36±0.07	0.92±0.12	0.70±0.03	0.41±0.10

组别	脑桥			内囊后肢前部
组别	MK(±s)	MD[mm²/s，M(P₂₅，P₇₅)]	FA(mm²/s，±s)	MK	MD(mm²/s)	FA(mm²/s)
A1组	1.19±0.11	0.63(0.61，0.65)	0.48±0.11	1.13±0.11	0.68±0.04	0.63±0.05
A2组	1.18±0.11	0.62(0.60，0.64)	0.48±0.11	1.14(1.07，1.26)^a	0.67(0.64，0.70)^a	0.65(0.60，0.69)^a
A3组	1.20±0.10	0.62(0.60，0.65)	0.49±0.10	1.20(1.09，1.28)^a	0.67(0.63，0.70)^a	0.66(0.61，0.70)^a
A4组	1.20±0.09	0.62(0.60，0.65)	0.48±0.10	1.17±0.13	0.67(0.63，0.70)	0.65±0.06
对照组	1.05±0.12	0.64(0.61，0.66)	0.47±0.08	1.18±0.14	0.67±0.05	0.67±0.06
组别	放射冠			皮层下
组别	MK	MD[mm²/s，M(P₂₅，P₇₅)]	FA(mm²/s，±s)	MK(±s)	MD(mm²/s，±s)	FA(mm²/s，±s)
A1组	1.14(1.05，1.18)^a	0.64(0.61，0.66)	0.39±0.10	1.00±0.08	0.68±0.04	0.44±0.11
A2组	1.13±0.08	0.63(0.61，0.66)	0.36±0.10	0.96±0.13	0.68±0.05	0.43±0.10
A3组	1.15±0.10	0.63(0.60，0.66)	0.37±0.10	1.00±0.13	0.68±0.04	0.47±0.11
A4组	1.14±0.10	0.63(0.60，0.66)	0.36±0.10	0.99±0.13	0.68±0.04	0.46±0.11
对照组	1.10±0.13	0.63(0.60，0.66)	0.36±0.07	0.92±0.12	0.70±0.03	0.41±0.10

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